As a sole proprietor, you may be looking for a cost-saving benefit solution. The SOCA Benefit Plan is a multiple
employer welfare arrangement (MEWA) that offers predictable rates and competitive benefits usually reserved
for larger groups. This means eligible businesses join together to share in the overall claims risk. By being part
of a larger, self-funded pool, they have financial protection backed by Anthem’s stop loss coverage.
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STEADY RATES, RICH BENEFITS ARE YOURS WITH THE SOCA BENEFIT PLAN
In addition to financial protection, sole proprietors receive:
Competitive rates.
Fixed, predictable monthly payments.
A variety of plan designs.
Anthem’s broad Blue Access PPO Network
and Essential Rx drug list.
Coverage for claims run-out/terminal
liability coverage.
Expanded wellness offerings and innovative
tools, programs and resources that all work
together to improve health and lower costs.
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CHAMBERCHAMBER
Who is eligible?
The SOCA Benefit Plan is available to sole
proprietors who1:
} Meet underwriting requirements.} Work more than 30 hours per week
(attested to on the employee application).} Submit a cover page for Form 1040 with Schedule C
or Form 1040 with Schedules F and SE.} Are headquartered in Ohio.} Are a member in good standing with a chamber
of commerce that is qualified to offer the SOCA
Benefit Plan.
These chambers must belong to one of the following
Associations/Alliances:
} Southern Ohio Chamber Alliance (SOCA)} Northern Ohio Area Chambers of Commerce (NOACC)} Central Ohio Chambers of Commerce (COCC)} Dayton Area Chamber of Commerce (DACC)} Youngstown/Warren Regional Chamber (YWRC)
The Anthem difference
Eligible businesses have peace of mind knowing that
Anthem has been serving millions of members in Ohio
for more than 75 years and is:
} Part of the nation’s largest health benefits company.
} Part of the BlueCard® program through the Blue Cross
Blue Shield Association, which includes more than
96% of hospitals and 95% of doctors in the country.2
} Highly experienced in alternate funding plans.
Frequently asked questions
Are there any restrictions on the number of sole proprietors
eligible to participate in the plan?
Regulations limit sole proprietor membership to 10 percent of
total SOCA Benefit Plan membership.
If a sole proprietor has employees, are they eligible?
To be eligible, a sole proprietor with employees must register
as an employer with the IRS. The IRS will assign an Employer
Identification Number (EIN). For the purposes of the SOCA
Benefit Plan, the sole proprietor will be considered an
employer group once the EIN has been assigned.
If a sole proprietor without employees hires employees
during the plan year, do they need to re-apply?
A new employer application indicating EIN should be provided,
but no rating change will happen until renewal.
If a sole proprietor with employees is enrolled as an
employer group, but drops to one employee during the plan
year, do they need to re-apply?
A new employer application indicating sole proprietor should
be provided, but no rating change will happen until renewal.
How does a sole proprietor differ from an LLC or S Corp
comprised of one individual?
Whether a business is a sole proprietor, LLC or S Corp is based
on how the individual has legally structured and filed the
business. A sole proprietor is an unincorporated business
owned and run by one individual. LLC and S Corps are filed as
corporations and have EINs. An LLC files a Schedule SE and a
Schedule K-1. An LLC has an EIN. If an LLC has only one
enrolling they are a “group of one” which is not eligible to
participate in the SOCA Benefit Plan. A sole proprietor files a
Schedule C or Schedules F and SE.
What if a sole proprietor was just established and does not
have tax documents yet?
The sole proprietor would not be eligible to participate in the
SOCA Benefit Plan until tax documents are available.
Is the SOCA Benefit Plan required to provide a proposal or
enroll a sole proprietor upon request?
No, a sole proprietor can be declined by underwriting.
How can a sole proprietor meet the requirement to
demonstrate that they work 30 hours?
The Anthem employee application asks for full-time hours
worked. A sole proprietor must attest that they are working the
required 30 hours.
For access to high-quality health care at an
affordable cost, you can rely on the SOCA
Benefit Plan. Contact your broker for a quote.
If you don’t have a broker, call 1-844-Med-Ohio
or visit 844medohio.com.
HIGH-QUALITY CARE DESIGNED FOR WHOLE-PERSON HEALTH
Count on Anthem’s outstanding core health and wellness programs and services, including 24/7 NurseLine, Future Moms, ConditionCare, LiveHealth Online and more.
1 Sole proprietors are eligible to participate in the SOCA Benefit Plan. However, because of regulatory requirements, total sole proprietor membership cannot exceed 10% of the total membership in the plan. “Groups of one” are not eligible to participate in the SOCA Benefit Plan. Final participation and premium equivalent rates must be approved by Underwriting and the SOCA Benefit Plan.
2 Blue Cross Blue Shield Association website: Personalized HealthCare Nationwide (accessed September 2019): bcbs.com.
Anthem Blue Cross and Blue Shield is the trade name of Community Insurance Company. Independent licensee of the Blue Cross and Blue Shield Association. Anthem is a registered trademark of Anthem Insurance Companies, Inc.